💔 Cholesterol Climbing in Perimenopause? Here's What You Need to Know

Julie Gledhill, NNCP
Jun 18
3 min read

You’re eating pretty well, trying to move your body, and suddenly—bam—your doctor says your cholesterol is high. If this sounds familiar, you're not alone. Many women see their cholesterol spike during perimenopause, even if nothing major has changed in their habits.

So what’s going on? Let’s break it down—and more importantly, look at what you can do to support your heart (and hormones) with simple, nourishing strategies.

🌀 What’s Actually Happening to Cholesterol in Perimenopause?

As estrogen begins to fluctuate and decline in your 40s and 50s, it has a direct impact on your cardiovascular system—and especially your cholesterol levels.

Estrogen is protective. It helps:

Keep LDL (“bad” cholesterol) in check
Boost HDL (“good” cholesterol)
Reduce inflammation in your arteries

When estrogen drops, those benefits start to fade. The result?

LDL cholesterol often rises
HDL may drop
Triglycerides can increase
Plaque build-up risk increases (hello, heart disease risk)

So it’s not just about what you’re eating—your hormones are shifting the landscape.

❗Why It Matters More Now Than Ever

Before menopause, women typically have a lower risk of heart disease than men. But that advantage shrinks after age 50, and heart disease becomes the #1 cause of death in women.

That’s why this stage is the perfect time to check in, reset, and give your heart the nourishment it deserves.

💪 What You Can Do to Help

Good news: You don’t need a crash diet or to cut out everything you love. Small, consistent shifts make a big difference.

Here’s where to start:

🥑 1. Upgrade Your Fats

Swap out saturated fats (like butter, fatty cuts of red meat, and ultra-processed snacks) for heart-friendly fats:

Avocados
Olive oil
Fatty fish (salmon, sardines, mackerel)
Nuts and seeds (especially walnuts, flax, chia)

These fats help raise HDL and lower LDL naturally.

🌾 2. Fiber Is Your Friend

Soluble fiber binds to cholesterol in the digestive tract and helps your body excrete it.

Aim for:

Oats
Lentils
Apples, pears
Ground flaxseed
Chickpeas & beans

Try to get 25–30g of fiber per day, and increase slowly to avoid bloating.

🚶 3. Move with Purpose

Exercise can:

Raise your HDL
Lower triglycerides
Improve insulin sensitivity

Even 30 minutes of brisk walking 5 days a week makes a big difference. Add some resistance training (hello, bone strength!) for bonus benefits.

💤 4. Sleep + Stress = Cholesterol Shifters

Lack of sleep and chronic stress = more cortisol = higher triglycerides and inflammation.

Prioritize 7–8 hours of sleep
Try breathwork, meditation, or a walk outdoors daily
Cut back on late-night scrolling or working

🍷 5. Rethink Alcohol & Sugar

These both increase triglycerides and mess with your blood sugar and hormones.

Try:

Swapping wine for sparkling water with a citrus twist
Reducing added sugars in sauces, coffee drinks, and snack bars

💡 Bottom Line: It’s Not Just About the Numbers

High cholesterol in perimenopause is often your body’s way of asking for more support—not punishment or restriction. Instead of fearing the numbers, use them as information.

Your hormones are shifting, but with the right tools, your heart and health can stay strong and steady.